EVALUATING THE SOCIETAL BURDEN OF PSORIASIS AND THE INDIRECT COST IMPACT OF TILDRAKIZUMAB IN EUROPE: A REAL-WORLD EVIDENCE-BASED MODELING STUDY
Author(s)
Matthias Augustin, MD1, Rachel Sommer, MD1, Bjoern Schwander, BSc, MA, RN, PhD2, York Francis Zoellner, PhD, MSc3, Buelent Akmaz, PhD4, Antonio Sarno, PhD4, Ulrich Mrowietz, MD5.
1University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany, 2General Manager & Founder, AHEAD GmbH, Bietigheim-Bissingen, Germany, 3Hamburg University of Applied Sciences, Hamburg, Germany, 4Almirall S.A., Barcelona, Spain, 5University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany.
1University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany, 2General Manager & Founder, AHEAD GmbH, Bietigheim-Bissingen, Germany, 3Hamburg University of Applied Sciences, Hamburg, Germany, 4Almirall S.A., Barcelona, Spain, 5University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany.
OBJECTIVES: To quantify the 2-year societal productivity burden of moderate-to-severe plaque psoriasis and to estimate the potential reduction in indirect costs associated with tildrakizumab using European real-world evidence (RWE).
METHODS: An Excel-based economic model was developed using 24-month data from the European POSITIVE RWE study. Work Productivity and Activity Impairment (WPAI) outcomes (absenteeism, presenteeism, overall work impairment) were collected at weeks 16, 28, 52, 78, and 104; trajectories between assessments were estimated using linear interpolation. Multiple imputation served as the base case for missing data. Indirect costs were calculated using a human capital approach across nine countries (Austria [n=88], Belgium [n=38], France [n=193], Germany [n=183], Italy [n=57], Spain [n=108], Switzerland [n=69], Netherlands [n=21], UK [n=28]), restricted to working-age populations, applying country-specific psoriasis prevalence, biologic uptake, unemployment rates, and national labor cost data. Within-patient productivity at baseline (not adequately treated) was compared with productivity after tildrakizumab over two years. Year 2 costs and effects were discounted at 3%. Probabilistic sensitivity analyses explored uncertainty in WPAI and prevalence inputs.
RESULTS: Over two years, cumulative discounted productivity losses in not adequately treated patients averaged €23.6k per patient (95% CI: €22.1-€25.1k), corresponding to approximately €25.7bn (€19.9-€32.9bn) across nine European countries. Treatment with tildrakizumab was associated with a 49% reduction in total indirect costs, translating to average potential savings of €11.6k (€10.1-€13.2k) per patient and approximately €12.6bn (€11.9-€13.2bn) across nine countries. Improvements were consistently observed across absenteeism, presenteeism, and overall work impairment outcomes. In an exploratory scenario assuming 0% biologic uptake, total baseline productivity burden increased to approximately €33.3bn (€25.5-€43.2bn) across the nine-country population.
CONCLUSIONS: Our modeling study indicates that effective psoriasis management, such as tildrakizumab, can substantially reduce societal costs related to work impairment. These findings support improved access to biologic therapies and highlight the relevance of incorporating indirect costs into payer decision-making.
METHODS: An Excel-based economic model was developed using 24-month data from the European POSITIVE RWE study. Work Productivity and Activity Impairment (WPAI) outcomes (absenteeism, presenteeism, overall work impairment) were collected at weeks 16, 28, 52, 78, and 104; trajectories between assessments were estimated using linear interpolation. Multiple imputation served as the base case for missing data. Indirect costs were calculated using a human capital approach across nine countries (Austria [n=88], Belgium [n=38], France [n=193], Germany [n=183], Italy [n=57], Spain [n=108], Switzerland [n=69], Netherlands [n=21], UK [n=28]), restricted to working-age populations, applying country-specific psoriasis prevalence, biologic uptake, unemployment rates, and national labor cost data. Within-patient productivity at baseline (not adequately treated) was compared with productivity after tildrakizumab over two years. Year 2 costs and effects were discounted at 3%. Probabilistic sensitivity analyses explored uncertainty in WPAI and prevalence inputs.
RESULTS: Over two years, cumulative discounted productivity losses in not adequately treated patients averaged €23.6k per patient (95% CI: €22.1-€25.1k), corresponding to approximately €25.7bn (€19.9-€32.9bn) across nine European countries. Treatment with tildrakizumab was associated with a 49% reduction in total indirect costs, translating to average potential savings of €11.6k (€10.1-€13.2k) per patient and approximately €12.6bn (€11.9-€13.2bn) across nine countries. Improvements were consistently observed across absenteeism, presenteeism, and overall work impairment outcomes. In an exploratory scenario assuming 0% biologic uptake, total baseline productivity burden increased to approximately €33.3bn (€25.5-€43.2bn) across the nine-country population.
CONCLUSIONS: Our modeling study indicates that effective psoriasis management, such as tildrakizumab, can substantially reduce societal costs related to work impairment. These findings support improved access to biologic therapies and highlight the relevance of incorporating indirect costs into payer decision-making.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE125
Topic
Economic Evaluation, Epidemiology & Public Health, Health Service Delivery & Process of Care
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies, Work & Home Productivity - Indirect Costs
Disease
Biologics & Biosimilars, Sensory System Disorders (Ear, Eye, Dental, Skin), Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)